In terms of safety, most of these sweeteners have been found to be consumed within safe limits as per the acceptable daily intake (ADI) which measures the level beyond which it gets toxic. Most of them (being sweeter than sugar) are used in negligible amounts when compared to their ADI.
Most artificial sweeteners fall into a class that is referred to as “non-nutritive” meaning that they have no nutrient value to the human body, however many of them still stimulate an insulin response.
Insulin: The secretion can be stimulated through carbohydrates (glucose) and protein. It is important to gauge the overall effect while selecting foods in the context of avoiding “insulin spikes”. Protein does not stimulate it as much as glucose. It also helps maintain lean mass which leads to lower basal insulin in the long run.
The idea of using sweeteners in the context of a very low carb/keto diet is just not replacing calories/sugar but also keeping insulin spikes low. The other important point to consider is the effect on gut bacteria which leads to inflammation if disturbed. Thus, the frequency of use matters here.
Now let’s analyze a few sweeteners ideal for FREQUENT use.
| Name | Insulin response | Gut bacteria | Use |
| Aspartame | Low | Not disturbed | Yes* |
| Acesulfame potassium | High | Disturbed | No |
| Sucralose | High | Disturbed | No |
| Stevia | Low | Not disturbed | Yes |
| Monk Fruit | High | More study needed | No |
| Erythritol | Low | Low | Yes |
| Maltitol | High | More study needed | No |
| Xylitol | High | More study needed | No |
| Fructooligosaccharides (FOS) | Low | Low | Yes |
Shweta Bhatia, Registered Dieteitan, Mind Your Fitness!